|
||||
Application Form | ||||
| Name of Candidate | Pankaj Kumar |
911029040074 
|
||
| Mother's Name | Jago Devi | |||
| Father's Name | Laxmikant | |||
| Date of Birth * | 03-Jan-1985 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | LAXMIKANT RAMJANIPUR WARD NO 05.PO KALGIGANJ KAHALGAON BHAGALPUR BIHAR.PIN 813203 | |||
| Mobile No. | 6201277281 | |||
| Email Address | punajsmith@gmail.com | |||
Course Details |
||||
| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
||||
| Center Code | 91102904 | |||
| Center Name | Computer Training Institute | |||
| Center Address | Kahalgaon | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||